Approved for use
through 7/2000 under the condition that HCFA continues to monitor
the burden imposed by these cost reports, in particular any
reductions that can be attributed to electronic submission. Prior
to the next submission for OMB review, HCFA must submit a
correction worksheet for these reductions with a detailed
explanation of the assumptions underlying the revised burden
estimate.
Inventory as of this Action
Requested
Previously Approved
07/31/2000
07/31/2000
05/31/1999
7,000
0
7,000
1,372,000
0
1,372,000
0
0
17,635,096,000
The Skilled Nursing Facility and
Skilled Nursing Facility Health Care Complex Cost Report is the
cost report to be used by free-standing SNFs to submit annual
information to achieve a settlement of costs for health care
services rendered to Medicare beneficiaries.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
Skilled Nursing Facility and Skilled Nursing Facility Health Care Complex Cost Report -- 42 CFR 413.13, 413.20, 413.24, and 413.157